5 West Nursing

OPUSite

Since going live on August 15, 2006, the dust has now began to settle. What was then an exciting event, turned out to be less exciting as the weeks go by.

Today, it’s just the same old grind… nothing’s changed. Most of us are probably thinking… “let’s get back to the old pen and paper system!”. I don’t blame you, since it doesn’t seem like the new system has given us the efficiency we though we would have. All it’s done so far is add unnecessary work on our already overloaded workload. No wonder incremental overtimes are starting to become a problem. And those of us smart enough to take advantage of the situation, exploit the fact that our system is just so slow… we get to stay longer than we should. Hey, I’d like to jump on the bandwagon, but I got kids to take to school… maybe later 🙂

For all it’s worth, this page is dedicated to our new system…OPUS Clindoc, where it is “Patient focused. Business minded.“. Think of it as a “suggestion” page of some sort. I’ve heard some co-workers say, “nothing happens, so I don’t talk”. I’m sorry to hear that. But if we care about our facility and the way things should go, then we should speak up, especially with our new clinical system. After all, UHS is a paying customer… and you know what they say, “THE CUSTOMER IS ALWAYS RIGHT!”. Having said that, lets get on the ball!

If you have any suggestions or comments or anything on your mind that you think could improve on the way our new system should work, then drop us a comment. Remember, the more voices, the louder we are, the more we get heard… all for the good of UHS (if they do care about us like they say they do).

As for OPUS Clindoc, I’d like to add a line to their slogan… “Patient focused. Business minded. Nurses’ nightmare!” — what more can I say?!

It would be nice to have the date and time defaulted on the fields when you chart on a new occurence. This way, you save time from typing in the date and time everytime you need to chart. This automacity is something that computers systems should be able to perform in order to make work more efficient. Should the user need to type in a different time and date, then they can do so, only when needed. This will save keystrokes and therefore save time.

Minimize the use of dropdown boxes if the form allows. This will enhance data entry in that users will not have to click on the “down arrow” to drop down the list, then click on their choice. Instead, use checkboxes which present the user with readily visible choices, and therefore require only 1 click vs 2 clicks to enter data. For example in the Braden Risk Assessment form, checkboxes will speed up data entry process.

Please integrate the Braden Risk Assessment form into the Shift Assessment form just like it has been on paper. This will save time on waiting for the chart/form to “load” because you only have to wait (and wait) for only 1 chart/form to load.

It would be nice if the screen defaults to the Care Grid when you click on the patient’s name instead of a blank work area. This way we minimize clicks and get to our work faster instead of clicking on patient’s name, then “Care Grid”… after all, this is the focus of our clinical documentation.

Reorganize care plan so that problems appear based on the patient’s diagnosis, then goals and interventions appear based on the patient’s problem list instead of having to choose from a universal list of goals, narrow goals down based on the problem presented. It only makes sense.

Please rearrange fields so that it follows a LOGICAL pattern. For example, SBP/DBP and (MAP) instead of having MAP all the way in the bottom of the page. This enhances data entry as data is entered in a LOGICAL way instead of having to mouse click and jump from one point to another and back. IT JUST MAKES SENSE don’t you think?

I haven’t scanned your sight and figured out where you’re from (which hospital, which state, etc.) I’m too tired. But our hospital has used Clindoc since it opened in 2003.

It’s a pain in the ass. It’s expensive, slow, redundant, and NOT user friendly. It makes nurses chart in an alien world completely contrary to their training and expertise. It makes hospitals spend money on training nurses how to chart. It makes an IT department waste time on teaching when it should keep computers up and running to supply valuable lab and test results in a jiffy, 24/7.

Clindoc may have been designed by nurses, but they obviously didn’t have any programming skills. The programmers obviously didn’t have any charting skills. Common sense doesn’t apply. Non-sequiter questions and boxes are splayed throught clindoc. Clindoc makes my charting into subjective statements when I don’t want subjective statements. (Dressing “appears” instead of dressing IS, for example.) Usefull dates and times aren’t carried over but have to be laboriously re-entered by each and every nurse. Screen refresh times are outrageous which means processor time is inadequately administered. We have lockups and lost information and charting.

Registry staff doesn’t have to use it and they get paid more. And they have more time for patients and doctors and families because their not camped out in front of a computer, clicking and closing, clicking and opening, and hunting for information that should be right there in front of you, not presented “in a clean desk-top style, user-friendly interface.” What a crock.

Clindoc is fine if you have one patient. But add a family and a doctor to tend to and you’re wasting your time.

But if that’s what the hospital wants, I’ll spend the money. We actually had “superusers” flown in from Texas to teach the nurses clindoc in Las Vegas. When JACHO came by, they shut down clindoc and passed certification just fine.

I’d LOVE to find out who the salesman was. If you go to the Clindoc Opus website, it’s a nice clean job of advertising but NOTHING on support. You’ve got to CALL for help.

I placed a call on a Saturday morning. They called back Sunday afternoon. The greatest day at work is when CLINDOC IS DOWN and we paper chart. We have it as easy as registry…but we don’t make the money they make.

Amen, and AMEN and AMEN! I totally hear you! We’re probably from the same sister company… the only company that uses Clindoc. Like you said (and I concur), it is the most ridiculous system I’ve ever seen. I’m a nurse and I program too, maybe they should have hired me! 🙂 Unfortunately, the programmers do not know how to document, they aren’t clinicians and they don’t think like a nurse thinks. Just like you, I’d like to know who the salesman was, maybe we can learn from him on how to sell snow to snowmen! Again, AMEN… it’s glad to know that at least there’s someone out there that has a brain. You know what they say… “great minds think alike!”

Our Clindoc is “adminstered” by a light-duty, obese, elderly, copd nurse with no computer background or training…just fly-by-night that fell into the position when this joint opened up. She’s never had to do patient care AND clindoc. She just adds junk as she feels fit to add with no logic or reasoning.

Kind of like our “education department” that doesn’t educate patients…only makes pretty signs saying, “how to wash your hands,” and holds mandatory Jchoa.jcoah,..whatever, updates that you have to attend for 20 minutes on your day off.

The biggest fiasco occured years ago when the clindoc witch made the self-determination that all of your assessments should be recreated from scratch, completely negating the advantages of repetitive charting and data storage on a computer. Before that, you’d compare previous and present, click that you agree and move on. Pretty quick.

Now, you must laboriously re-enter ventilator settings, ett site measurements, etc., time and time again, both shifts, and after you enter it, it’s wiped out for the next user. She DOESN’T get it. We complained and she maintained the little check box for a ventilator and after you open the charting region, NOTHING is carried over…just the check box.

The “clean” interface is a joke. Information is always hidden behind a check box that you must check to make the material pop-up. Error messages don’t address the actual error, just a series of three advisory boxes. Then you must peruse the page to find it yourself, with hit and miss attempts to eliminate the errors.

The “tab” key won’t let you jump from box to box without moving from keyboard to mouse, keyboard to mouse. This is a standard programming feature in most any program Does yours work? Do you have the ability to suggest stuff and have it implemented? It’s like talking to a wall out here.

I wrote an 8 – pager on the problems and possible solutions to Clindoc and it’s tragedies. Our CEO met with me and proclaimed that he doesn’t like clindoc either, neither does our QA (that’s a laugh) department, but declared that “it’s here to stay.” So I gave up. But I do give personal inservices to the chosen few who ask. I can Clindoc on an icu patient in about 5 minutes. I put EVERYTHING in comments and ignore the check boxes. Since our QA exists only of clearing the “sirens,” (Hate that term) nobody reads your charting. Out of sight, out of mind, put whatever the hell you want to put in there. And I believe there is an excellent chance that no one has the brains to retrieve it.

The vital signs modules aren’t conducive to ICU and don’t download. Our monitors are linkable, but they don’t use it. We hand enter vs on a written flowsheet. Neuro is done in writing and on clindoc, and it’s redundant. She’s got little goofey comments on the assessments like a checkbox for apnea that doesn’t address anything else. There’s no paralleism. Charting is in one style on one page and changes on another. You can display the charting times and sort by “dueness,” whatever the hell that’s supposed to mean, creating her own words.

The computer lags everytime at “integumentary.” That’s when you reach for your coffee, so it’s a nice break. The “role-around” computers have 15 inch screens. We’re all in our 40’s with presbyopia. SHE doesn’t have to use em’…

My biggest beef is that we’re getting 3 patient assignments (I had 4 vents last week) and by the end of the day when you’ve got time to complain, you’re just sick of it all and you say screw it and go home.

The money is fair, over $40 an hour for most of us, and with a union looming, we may have some more stroke. I don’t personally like unions, but I’m ready to screw em’ back.

Well I hate to say it but…..we are going live with clindoc July 15th and we feel like we know nothing. We have been to two classes also on our days off and they went so fast that you could barely keep up. The shift assessment is the same as the admission assessment, I work on a medical floor and will have anywhere from 6 to 9 patients and have been a nurse for 35 years and personnaly do not feel I need to do all the reflexes on all patients every 12 hours! I have looked through the entire assessment forms for admission etc and really feel like I will be there 24 hours to document on all 6 to 9 patients. Our head nurse is trying to have the forms changed to reflect what we need, but from what I have read this probably won’t happen but she said if they didn’t change it she would just write a policy as to what was required on the assessments and that would cover us legally when we skip over certain things. I suppose we will just have to wait and see what happens.

All I can say is … “woe unto the inhabitants of the earth!” With this piece of junk software you might as well pack your bags, bring a tent and sing Kum Ba Ya around the bonfire because you’ll be practically spending 50% of your time charting. It takes approximately 20 min to fill up and admission assessment and about 15 min to do shift assessment, of course factoring in interruptions that you’ll have to respond to while you do your documentation. 6 to 9 patients will definitely eat up your time, not to mention the slow response of the system, the multiple clicks and double entries you’ll have to make, plus canceling redundantly scheduled assessments.

I used to work in telemetry with 5 to 8 patients, and it was tough. Now I’m in ICU, with 2 to 3 patients the most, definitely better than 6 to 9 patients. The first few months will be tough… you’ll have a lot of reason to go overtime tho… take advantage of this (LOL), then once you’re used to the system, you can make use of the “comments” section so you don’t have to go through a convoluted array of check boxes and drop down menus. Eventually the excitement will die off, and you’ll hate going to work! This piece of software is a drag to use. It doesn’t make any sense and it doesn’t conform to the way we work, although I can say I’ve made a tremendous amount of suggestions which they have incorporated that made it a little better, but overall they need to redesign the system from scratch. I do want to meet the marketing genius behind this because they practically sold snow to snowmen. Overall management wouldn’t care because they are all afraid. I hope your director has balls and would defend your unit from stupid decisions made by corporate. Good luck!

Well, we started live with clin doc, portal and hms on sept 1st and things are going fairly well. They did change the assessment form. It does take longer to do an admission assessment than it had before but I have not had any overtime because of it so far. The portable computers are a nightmare at this time, you cannot move them from one place to another without losing connectivity, but Information service is suppose to have things changed around soon to see if the receivers can be relocated. They have increased staffing for 2 weeks, so we can have time to learn the system and get use to how it functions, the nurse manager pulled two people off the floor to get a book together on how to print certain things for the charts, so we have a reference book for that part. So far so good. Our manager really tries to help make things go smoothly and so far it has.